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Abstract

The use of micro- and nanoparticles is rapidly advancing and has been most commonly used in medical and biological research that offers an encouraging scope in broad range of disciplines. Manipulation of the biomaterials to their micro- and nano-scale renders their properties and behavior different from that of the same material in the mass scale and make them more reactive than large particles. The removal of tooth structure and its restoration with synthetic material to solve the problems caused by dental caries, trauma and fracture is a practice nearly as old as dentistry. Efforts are made to create micro- and nanomaterials that can revolutionize these ancestral therapies and dental procedures. The use of these materials had shown some promising applications in caries control, endodontic therapy, regenerative dentistry, periodontology and oral biofilm management. This review aims to discuss the recent advances and future potential of polymer-based micro- and nanoparticles in dentistry.

Introduction

The prevention of tooth decay, treatment of bone loss and periodontal disease are ongoing challenges in dentistry. According to CDC, tooth decay is the most frequent childhood disease 5 times as common as asthma. LA Times came up with the fact that 42% of children are expected to have some decay by the age of 2-12 (Mascarelli, 2011). For example, in 2015-16, a UK report shows that 9.8% rise in removal of one or more teeth in children aged 10 and under (Howell, 2016). Periodontal diseases are the most common infections due to the overgrowth of the dental plaque that may increase the risk of heart disease and it is estimated that 47.2% of adults aged 30 years and older has some form of periodontal disease (Dhadse, Gattani, & Mishra, 2010).

With the emergence and increase of such dental problems and continuing concerns on healthcare costs, many researchers have tried to develop new and effective treatment regimes. Such problems and needs have led to the resurgence in the use of micro- and nanomaterials in order to revolutionize the ancestral therapies and dental procedures. For example, liquids and pastes containing nano-apatite’s have been used remineralization of early sub micrometer sized enamel lesions and the role of nanoparticle in the control of the oral biofilm has also been recognized (Figure 1) (Besinis, De Peralta, Tredwin, & Handy, 2015; Hannig & Hannig, 2010). Similarly, micro-/nanoparticles that can deliver antibiotics and bioactive compounds have been used to treat periodontal diseases (Yao et al., 2014).

Figure 1.

(A) Diagram shows the presence of NPs (isolated particles or agglomerates) in saliva and the structure of dental tissues. The pellicle covers the superficial layer of enamel, and the oral biofilm develops on the pellicle surface. The characteristic hexagonal shape of the enamel crystallites is apparent and also the presence of the dentinal tubules in the underlying tissue of dentine. The NP–ion–protein complexes do not adhere directly to the tooth surfaces, but adhesion occurs either to the pellicle layer or the developing biofilm. (B) Schematic diagram of the oral environment, oral biofilm, and dental mineralized tissues showing the distribution of NPs and ions. Natural saliva normally contains a range of ions and proteins. In the presence of NPs, NP–ion–protein complexes are formed. Oral conditions promote particle agglomeration that results in particle sedimentation onto the dental surfaces. The pellicle has a globular structure and its proteinaceous layer facilitates the adherence of the early colonizing species necessary for the oral biofilm development. The oral biofilm and pellicle act as diffusion/permeation barriers to NPs preventing them from reaching the enamel–pellicle interface. Certain ions (F–, Cl–, SiO44–, Zn2+) are more abundant near the external surface of enamel, while others (Na+, Mg2+, CO32–) are found at higher concentrations near the dentino–enamel junction. The most commonly ions found in dentine are F–, Na+, Mg2+, and CO32–.

Application of micro-/nanotechnology in dentistry aims at using these materials and theories to enhance prevention, diagnosis and treatment of injured tissues at the molecular and micro molecular levels. The high surface area to volume ratio of these materials has reportedly shown to improve the biomaterial-biological interactions (Yong, 2014). Their ability to penetrate inside locations that are inaccessible make them best suited for various site-specific delivery (Cristina Buzea & Kevin, 2007). Moreover, their stability during storage as well as in biological fluids makes them advantageous in many ways. The shape of these materials enhances their surface reactivity and renders high antibacterial action in comparison to other formulations (Khodashenas & Ghorbani). Although still evolving with their developments at infancy, these fields provide an array of possibilities that benefit the patient's health by eliminating or reducing pain associated with conventional procedures.